Tension Subcutaneous Emphysema during Laparoscopic Surgery Treatment of Colon Cancer: A Case Report

J. S. Chea; S. M. Chae; S. W. Moon

doi:10.1055/s-0032-1322616

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2014; 62(06): 531-534
DOI: 10.1055/s-0032-1322616

Case Report

Georg Thieme Verlag KG Stuttgart · New York

Tension Subcutaneous Emphysema during Laparoscopic Surgery Treatment of Colon Cancer: A Case Report

J. S. Chea

¹Department of Anesthesiology and Intensive Care, St. Paul Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

,

S. M. Chae

¹Department of Anesthesiology and Intensive Care, St. Paul Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

,

S. W. Moon

²Department of Thoracic and Cardiovascular Surgery, St. Paul Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

› Author Affiliations

Abstract

All articles of this category

Abstract

Carbon dioxide (CO₂) insufflation is now essential for most endoscopic surgeries, such as abdominal, pelvic, and neck endoscopic surgery. It is not uncommon for CO₂ leaks to occur unintentionally into subcutaneous tissue, later diffusing into a patient's bloodstream and resulting in hypercarbia. Regardless of the etiology of subcutaneous emphysema, a similar clinical management is required. Herein, we report on a case of tension subcutaneous emphysema and subsequent fatal ventilatory failure due to massive subcutaneous emphysema during laparoscopy. A timely blowhole incision is an effective intervention in an emergent setting like this case, although the patient had endotracheal intubation.

Keywords

tension subcutaneous emphysema - hypercarbia - blowhole incision

Full Text

References

References
1 Saggar VR, Singhal A, Singh K, Sharma B, Sarangi R. Factors influencing development of subcutaneous carbon dioxide emphysema in laparoscopic totally extraperitoneal inguinal hernia repair. J Laparoendosc Adv Surg Tech A 2008; 18 (2) 213-216
2 Williams JG. Malignant subcutaneous emphysema—a case report and discussion. Anaesth Intensive Care 1974; 2 (1) 69-72
3 Eveloff SE, Donat WE, Aisenberg R, Braman SS. Pneumatic chest wall compression. A cause of respiratory failure from massive subcutaneous emphysema. Chest 1991; 99 (4) 1021-1023
4 Conetta R, Barman AA, Iakovou C, Masakayan RJ. Acute ventilatory failure from massive subcutaneous emphysema. Chest 1993; 104 (3) 978-980
5 Herlan DB, Landreneau RJ, Ferson PF. Massive spontaneous subcutaneous emphysema. Acute management with infraclavicular “blow holes.”. Chest 1992; 102 (2) 503-505
6 Sherif HM, Ott DA. The use of subcutaneous drains to manage subcutaneous emphysema. Tex Heart Inst J 1999; 26 (2) 129-131
7 Gottlieb A, Sprung J, Zheng XM, Gagner M. Massive subcutaneous emphysema and severe hypercarbia in a patient during endoscopic transcervical parathyroidectomy using carbon dioxide insufflation. Anesth Analg 1997; 84 (5) 1154-1156